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Ovarian Hyperstimulation Disorder (OHSS)

Ovarian Hyperstimulation Syndrome (OHSS) is a condition that can occur as a result of ovarian stimulation during assisted reproductive techniques, particularly in vitro fertilization (IVF). It is a response to fertility medications used to stimulate the ovaries to produce multiple eggs. Here are some important points to know about ovarian hyperstimulation syndrome:

  1. Ovarian Stimulation: During IVF or other assisted reproductive techniques, fertility medications such as gonadotropins (follicle-stimulating hormone and luteinizing hormone) or medications that suppress natural hormone release (GnRH agonists or antagonists) are used to stimulate the ovaries. This helps promote the development of multiple follicles (fluid-filled sacs in the ovaries containing eggs) for retrieval.
  2. Ovarian Hyperstimulation Syndrome (OHSS): OHSS occurs when the ovaries overreact to the fertility medications, resulting in the enlargement of multiple follicles and the release of high levels of substances called vascular endothelial growth factors (VEGF) into the bloodstream. These substances can cause fluid to leak from blood vessels into the abdominal cavity and other body tissues, leading to the characteristic symptoms of OHSS.
  3. Symptoms of OHSS: The severity of OHSS can vary, ranging from mild to severe. Common symptoms may include:
    • Abdominal bloating or discomfort
    • Enlargement of the ovaries
    • Fluid retention and weight gain
    • Nausea or vomiting
    • Diarrhea
    • Shortness of breath
    • Decreased urine output
    • Ovarian cysts
    • Ovarian torsion (rare but serious complication where the ovary twists on its own blood supply)
  4. Risk Factors: Certain factors may increase the risk of developing OHSS, including:
    • Younger age
    • Polycystic ovary syndrome (PCOS)
    • History of previous OHSS
    • High number of follicles seen on ultrasound
    • High levels of estrogen during ovarian stimulation
    • Use of certain fertility medications
  5. Management and Treatment: The management of OHSS depends on the severity of symptoms. Mild cases typically resolve on their own within a week or two, with self-care measures such as rest, adequate hydration, and pain relief medications. In more severe cases, close monitoring, hospitalization, and medical interventions may be necessary to prevent complications. These interventions may include draining excess fluid from the abdomen, intravenous fluids, medications to suppress hormone release, or rarely, removal of excess fluid through a procedure called paracentesis.
  6. Prevention: To reduce the risk of OHSS, doctors carefully monitor ovarian response during ovarian stimulation. In some cases, the cycle may be canceled or the dose of fertility medications adjusted to minimize the risk. Triggering ovulation with a hormone called hCG (human chorionic gonadotropin) may also be modified or replaced with alternative medications to reduce the risk of OHSS.

It’s important to consult with a healthcare professional if you experience symptoms of OHSS or have concerns about your fertility treatment. They can provide appropriate guidance, monitor your progress, and manage any potential complications associated with ovarian hyperstimulation syndrome.

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